- Chronic MCL Laxity:
- power point slide show - often occurs from chronic repetive throwing which stresses the elbow in mid-flexion;
- in about 30 deg of flexion, neither the radial head nor the anterior joint capsule provide significant resistance to valgus stress, which leaves
the MCL vulnerable to overload;
- posteromedial olecranon impingement occurs which results in inflammation, chondral injury, and eventual osteophytes and loose body formation;
- this condition is demonstrated by posteromedial elbow tenderness as a valgus force is applied against the fully extended elbow; - osteochondrosis of medial epicondyle - in children the medial epicondylar physis is weaker than the MCL complex and chronic injury to this apophysis results
growth disturbances and overgrowth;
- diff dx: medial epicondylitis
- in the report by Rettig AC et al (2001), the authors evaluated 31 throwing athletes with ulnar collateral ligament injuries (from 1994 to 1997);
- the authors sought to determine what percentage of athletes could return to their sport without surgical intervention;
- nonop treatment included a minimum of 3 months’ rest w/ rehab exercises, allowed 42% of the athletes (N = 13) to return to
their previous level of competition;
- those who returned to sports did so at an average of 24.5 weeks after diagnosis;
- surgical repair:
- w/ proximal tears, consider reattachment thru drill holes in medial epicondyle;
- w/ intra-substance tears consider augmentation w/ palmaris longus;
- references:
- Traumatic Valgus Instability of the Elbow: Pathoanatomy and Results of Direct Repair

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Orthopaedics and the US Military

Text Author

Dr. Wheeless enjoys and performs all types of orthopaedic surgery but is renowned for his expertise in total joint arthroplasty (Hip and Knee replacement) as well as complex joint infections. He founded Orthopaedic Specialists of North Carolina in 2001 and practices at Franklin Regional Medical Center and Duke Raleigh Hospital.